Full-thickness unipedicle flap for lower eyelid reconstruction.

We developed a technique for lower eyelid reconstruction using a full-thickness unipedicle flap from the upper tarsal portion of the upper eyelid. The lost tissue is replaced with identical tissue from the ipsilateral upper eyelid. The technique is best suited to shallow defects of the temporal lower eyelid. The levator aponeurosis and Müller's muscle are recessed to avoid upper eyelid retraction. The key to performing this operation is a thorough knowledge of eyelid anatomy and preservation of its microvascular supply. This procedure has produced satisfactory to excellent results in 17 patients and offers the reconstructive surgeon several advantages over other techniques.